Anterior prompt for debridement and myoplasty femoral neck and head osteomyelitis

Abstract

The known anterior prompts to the femoral neck are non-traumatic, but they exclude the possibility of myoplasty and are not large enough for intra-articular sequestrectomy.Objective. The aim of the study was to develop an anterior prompt to the hip joint for sequestrectomy with myoplasty.Materials and research methods. For surgery neck and head of the hip osteomyelitis we perform a semi-oval incision in the projection of the femoral head, from the anterior spines of the ilium we cut off the tendons of the sartorius and rectus head of the quadriceps femoris muscles. An operating field is formed, which allows sequestrectomy to be performed. Plasty of the osteomyelitis cavity is performed with the proximal parts of the two anterior ileofemoral muscles. The operating field, if necessary, can be increased by temporary transection of the lumbar-iliac muscle tendon.Research results. The key to the anterior surgical prompt to the hip joint is the sartorius and rectus head of the quadriceps. The length of the surgical wound reaches 17–22 cm, and the width is 16–18 cm. With the mobilized proximal part of the sartorius muscle, we fill the entire bone cavity in the neck and head of the femur. Of the 12 operated patients, 11 (91.7 ± 7.6 %) had a stable long-term remission.Conclusion. The proposed approach is less traumatic and allows you to operate at an angle of about 90°. It complements the advantages of the known anterior prompts and is devoid of their disadvantages.